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Whats characteristic pigment deposition of PXF?
- ring like deposit on the ant lens capsule
- might not see it without dilation
- also on iris
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Diff PXF and PDS iris transillumination?
- PXF: seen at pupillary border
- PDS: see more periphery
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Race prevalence PXF?
northern european
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PXF associations?
- reduced dilation
- IOP spike
- weaker zonules: subluxation
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PXF and glaucoma?
- PXF + glaucoma: yes once optic neuropathy occurs
- PXF w/o: yes 10-50% conversion
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What type of glaucoma is assoc with PXF?
POAG
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PXF management considerations?
- POAG
- weakend zonules: cataract surgery
- IOP spikes
- no tx required if no POAG
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What is PDS?
abnormal loss of pigment form post iris and redistributed across ant eye
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What causes PDS?
rubbing of iris pigment epithelium on lens zonules
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What predispositions of PDS?
- big ant chamb
- bowed iris and posterior
- young, myopic, white, males
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What is krukenberg's spindle
abnormal golden pigment deposition on corneal endothelium seen in PDS
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What is scheie stripe?
during full dilation you can see pigment deposition on the zonules near the post lens capsule
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Pigment in the TM?
- PXF: segmental and patchy
- PDS: very dark, dense and diffuse
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What are some assoc of PDS to other conditions?
lattice degneration and retinoschisis
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how does PDS cause glaucoma?
- pigment accumulates in TM and impairs outflow
- IOP rises
- optic neuropathy
- conversion rate: 10-50% over 15 years
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Management of PDS?
- no glaucoma, no tx
- monitor IOP spike post dilation
- document iris contours
- monitor
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Prophylatic PI for pds?
- releives pressure, bowing of iris, rubbing
- increases better circulation
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DDx for PDS?
- PXF
- trauma+ RD: unilateral
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how does ant NV cause glaucoma?
- hypoxic signal sent from the post eye
- NV growth on iris and in AC angle
- obstructs angle
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What conditions cause iris NV?
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Management of NV glaucoma?
- difficult
- PRP
- antiVEGF
- otherwise extensive destructive surgery
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inflammatory glaucoma- ACG?
pupil blocked: nv, synechiae, iris bombe,
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inflammatory glaucoma- OAG?
inflammatory cells blocking TM or steroid use
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PSS?
- mild ant uv with HIGH IOP
- OAG
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steroid induced glaucoma?
spike rf: POAG, foh glaucoma, highy myopia, diabetes
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What is angle recession?
- abnormal widening of CB band due to separation of muscle fibres caused by blunt trauma to the eye
- blunt trauma compresses globe and equatorial expansion occurs
- POAG!
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how does angle recession cause glaucoma?
- disrumption of TM and laceration of CB: restriciton outflow
- can occur yearsss later
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phacolytic glaucoma?
- cataract leaking proteins in AC
- macrophages plug TM
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Phacomorphic glaucoma?
large lens blocks angle
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ICE and glaucoma?
- proliferation of abnormal corneal endo cells migrating across angle and onto iris
- blockage of TM
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episclearl venous pressure and glaucoma?
chronically raised episcleral venous pressure can make it more difficult for the aqueous to exit the eye
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